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Biomedical subjects

D Budman

Publications and source records attributed to D Budman.

35 records · Page 2Linked to original sources
PubMed1986

A comparative assessment of home versus hospital comprehensive treatment for advanced cancer patients.

A prospective comparative analysis of home and hospital comprehensive treatment for advanced non-ambulatory cancer patients was conducted. Patients were assigned to hospital (group A) and home (group B) treatment groups based on geographic location. Home treatment was provided by the Don Monti Home Oncology Medical Extension (HOME) program. A multidisciplinary health team, including an oncologist, oncology nurse, social worker, dietitian, and medical technologist, was transported to the home in a medically equipped van. Services included physical examinations, pain control, psychosocial interventions, chemotherapy and blood transfusions, nutrition consultation, and bereavement counseling. One hundred seventy-four patients were treated at home and 44 in the hospital. Pretreatment characteristics were similar for both groups, with the exception that age under 50 years was more frequent in the hospital group, and home patients were more likely to have gastrointestinal (GI) cancer. Medical benefits for home treatment included decreased narcotic analgesic requirements, decreased hospitalization and length of stay, and improved measurements of fat stores for female patients. Improved survival for home patients was related to Karnofsky performance status, since there was no difference in survival for sicker patients with lower performance status whether they received home or hospital treatment. Patient and family acceptance of home treatment was excellent. Comprehensive home treatment provided by a multispecialty oncology team is an effective alternative to hospitalization for terminal cancer patients.

Analgesics↗
PubMed1985

Phase-II trial of 4-demethoxydaunorubicin (DMDR) for advanced hypernephroma.

A phase-II trial of 4-demethoxydaunorubicin (4-DMDR) was performed in 21 patients with advanced renal cell carcinoma. The drug had demonstrated a broader spectrum of activity with less cardiotoxicity in preclinical evaluation than the parent compound daunorubicin. The starting dose was 12.5 mg/m2, with escalations to 15 and 17.5 mg/m2 in the absence of toxicity. Myelosuppression was the primary toxicity and cardiac toxicity was not seen in four patients who received four or more doses of DMDR. No responses were seen in 19 adequately treated patients, including 14 who had received no prior therapy.

Aged↗
PubMed1985

Phase I and II clinical and pharmacological study of 4-demethoxydaunorubicin (idarubicin) in adult patients with acute leukemia.

Fifty-two adults treated previously with either acute leukemia (43 patients) or blastic-phase chronic myelogenous leukemia (nine patients) received 4-demethoxydaunorubicin (20 to 45 mg/sq m) i.v. over 2 to 3 days. Three of the ten patients with acute lymphocytic leukemia achieved a complete remission (CR) lasting 5 to 7 weeks. Five of the 28 patients with acute nonlymphocytic leukemia achieved a CR lasting 5 to 80 weeks. All remissions were induced with one course of treatment with a median time to CR of 28 days (range, 22 to 40 days). None of the patients with blastic chronic myelogenous leukemia or secondary leukemia achieved a CR. The drug was well tolerated; mucositis (36%), nausea and vomiting (35%), and hepatic dysfunction (26%) were the most common side effects. Pharmacokinetic observations on five patients demonstrated multiphasic clearance of 4-demethoxydaunorubicin and extensive formation and prolonged retention of 4-demethoxy-13-hydroxydaunorubicin; that metabolite accumulated in plasma on repeated daily dosing. 4-Demethoxydaunorubicin has sufficient antileukemic activity in both acute lymphocytic leukemia and acute nonlymphocytic leukemia to warrant a prospective comparison, in combination regimens, against the conventional anthracyclines, daunorubicin and/or doxorubicin.

Acute Disease↗
PubMed1985

Evaluation of colonic neoplasia by flow cytometry of endoscopic biopsies.

Colonoscopy is a valuable and frequently used method in the evaluation of colonic neoplasia. Flow cytometry is a technique that can be used to diagnose malignancy. In this study, flow cytometry was used to evaluate colonoscopic biopsies taken from patients with suspected colonic neoplasia. Nineteen colonic biopsies were obtained and evaluated by this technique. Aneuploidy was demonstrated in six patients with carcinoma of the colon. In addition, abnormal DNA histograms were noted in two premalignant conditions (colonic adenoma and inflammatory bowel disease). The results show that flow cytometry can be applied to colonic biopsies and suggest that it may be of use in the diagnosis of malignant and premalignant conditions of the colon.

Adenoma↗
PubMed1985

Phase I and clinical pharmacological evaluation of 4'-deoxydoxorubicin in patients with advanced cancer.

We have conducted a Phase I and initial clinical pharmacological evaluation of 4'-deoxydoxorubicin (4'-DXDX), administering the drug i.v. on an every 21-day schedule to 60 patients with advanced cancer. Patients were treated at six dosage levels ranging from 10 to 35 mg/sq m. Leukopenia was the dose-limiting toxic effect, and no cardiac, renal, or hepatic toxicity was observed; stomatitis was not seen; and there were no drug-related deaths. Significant alopecia was rare at doses less than 35 mg/sq m, mild nausea and vomiting occurred in one-third of patients at myelosuppressive doses; 12 patients had a transient local urticarial reaction. In the 30 patients with measurable disease, two partial remissions were seen, lasting 5 months in a patient with a nasopharyngeal adenocarcinoma, and 7 months in a patient with endometrial adenocarcinoma. The recommended dose of 4'-DXDX for Phase II studies is 30 mg/sq m in good-risk patients and 25 mg/sq m in moderate-risk or heavily pretreated patients. Pharmacokinetic studies were carried out in ten patients, four of whom received 4'-DXDX at a dose of 10 mg/sq m and six at 30 mg/sq m. Disappearance of 4'-DXDX from plasma was triphasic with a rapid initial phase clearance showing a t1/2 alpha of 1 to 2 min and a prolonged terminal phase with a median t1/2 gamma in excess of 90 h in patients receiving 30 mg/sq m.

Adult↗
PubMed1984

Kappa-chain nephropathy associated with plasma cell leukemia.

A 45-year-old-woman had plasma cell leukemia (PCL) and mild renal insufficiency. Renal biopsy findings were compatible with kappa-chain nephropathy. Our case adds PCL to the list of plasma cell dyscrasias associated with kappa- and/or lambda-chain nephropathy.

Female↗
PubMed1981

Electron microscope cytochemical analysis of chronic myelocytic leukemia: a case report.

A patient with Philadelphia chromosome positive CML was studied to characterize the blast transformation. Peripheral blood and bone marrow at the onset of the blast crisis were evaluated with cytochemistry, chromosome analysis, cell surface markers, terminal transferase assay, and electron microscopy. Although light microscopic examination and cytochemistry suggested lymphoblastic morphology, ultrastructural cytochemistry demonstrated the myelomonocytic features of the transformation. This study suggests that electron microscopic cytochemistry is useful in evaluating the heterogeneous nature of the blast phase of CML.

Adult↗
PubMed1981

Association of monosomy 7 with myelodysplasia following chemotherapy for Hodgkin's disease: serial observations.

Myelodysplasia and acute nonlymphocytic leukemia following therapy for Hodgkin's disease are observed rather frequently. Herein, we describe a patient with this syndrome treated with prolonged chemotherapy (alone), having a monosomy 7 karyotype. Cytogenetic studies were performed serially during the myelodysplasia preceding overt leukemia. Review of the literature and relevance of these findings are discussed.

Adult↗
PubMed1981

Tamoxifen in unresectable hypernephroma. A phase II trial and review of the literature.

Estrogen receptors have been demonstrated in human hypernephroma (renal cell carcinoma). Antiestrogens have been demonstrated to have antitumor activity in animal models of this disease. A prospective trial of tamoxifen therapy was undertaken in 10 consecutive patients with unresectable hypernephroma. No major responses to tamoxifen were observed. A review of the literature on antiestrogen therapy for this tumor reveals 148 published cases of hypernephroma treated with tamoxifen or nafoxidine. The overall response rate was 7.4%. Antiestrogens appear to have little clinical usefulness in the treatment of advanced hypernephroma.

Adenocarcinoma↗
PubMed1971

Specificity of fixation loci for homocytotropic antibodies.

The heat-stable, homocytotropic antibody synthesized by guinea pigs to highly purified dextran has been studied by passive cutaneous anaphylaxis (PCA). Antibody arising in single guinea pigs was found to give PCA in some homologous recipients but not in others. Data are presented which indicate that the antibodies are bound in the skin of some animals to a greater degree than in that of others. This suggests some type of variability, perhaps allotypic, in the Fc portion of these immunoglobulins which relates to specificities of the loci where Fc becomes fixed in skin.

Animals↗
PubMedDate not supplied

Phase II study of diglycoaldehyde in malignant melanomas and soft tissue sarcomas.

A phase II study of diglycoaldehyde was conducted in 42 patients with malignant melanoma and soft tissue sarcoma. All patients received diglycoaldehyde at a dose of 2 g/m2 iv over 6 hours daily for 3 days. This was repeated every 28 days. Major toxic effects included phlebitis and azotemia, requiring dialysis in one patient. Of the 42 patients, 38 were evaluable for response. One objective response occurred in a patient with malignant melanoma. Diglycoaldehyde at this dose and schedule appears to have no role in the management of malignant melanoma or soft tissue sarcoma.

Adult↗
PubMedDate not supplied

Race and survival from breast cancer: based on Cancer and Leukemia Group B trial 8541.

PURPOSE: The purpose of this research was to evaluate the prognostic significance of race and survival in stage II breast cancer among women treated with adjuvant chemotherapy in the Cancer and Leukemia Group B (CALGB) trial 8541. MATERIALS AND METHODS: A total of 1572 patients with node-positive breast cancer were entered in CALGB trial 8541. This study opened in January 1985 and randomized patients to receive "high-dose," "standard-dose," or "low-dose" adjuvant CAF (cyclophosphamide, doxorubicin, and fluorouracil) chemotherapy. Patients were stratified according to treatment of the primary lesion (mastectomy or breast conservation), menopausal status, number of positive lymph nodes, and estrogen-receptor status. Twelve percent of the patients entered in this study were African-American, 84% were white, and 4% were of other racial backgrounds. RESULTS: African-Americans and whites were evenly distributed on all three arms. In a univariate analysis, African-Americans were more likely to have a reduced survival and shorter time to relapse than other patients. Race was moderately associated with tumor size, receptor status, and type of surgery. In a multivariate analysis, after adjusting for the dose of chemotherapy, number of lymph nodes, estrogen-receptor status, and age, race was no longer of prognostic significance. DISCUSSION: After adjustment for other well-recognized prognostic factors, race appears to have no independent prognostic significance for survival from stage II breast cancer among women receiving adjuvant CAF chemotherapy.

Black People↗